MEDICARE: ORTHOPAEDIC CLINIC OF DAYTONA BEACH PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician		FL
2	332B00000X	Durable Medical Equipment & Medical Supplies		FL

General Provider Information

NPI Number	:	1164977534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOPAEDIC CLINIC OF DAYTONA BEACH PA

Provider Business Mailing Address
First Line	:	1865 LPGA BLVD
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-7108
Country	:	US
Telephone Number	:	386-255-4596
Fax Number	:	386-258-3561

Provider Business Practice Location Address
First Line	:	17 OLD KINGS RD N STE K
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32137-8283
Country	:	US
Telephone Number	:	386-255-4596
Fax Number	:	386-258-3561

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALBERT WILLIAM GILLESPY
Credential	:	MD
Telephone Number	:	386-255-4596

Provider Enumeration Date	:	08/16/2016
Last Update Date	:	08/02/2024

Similar Medicare Providers

1538949672 — PIVOTAL HEALTH SYSTEMS LLC
Practice Location Address:

17 OLD KINGS RD N STE E
PALM COAST, FL
32137-8283

Practice Phone: 386-283-6269
Practice Fax:

1164099552 — DR. JOSHUA WRIGHT DC
Practice Location Address:

17 OLD KINGS RD N STE E
PALM COAST, FL
32137-8283

Practice Phone: 386-283-6269
Practice Fax:

1801893854 — GREGORIO ALFONSO CISNEROS MD
Practice Location Address:

17 OLD KINGS RD N STE J
PALM COAST, FL
32137-8283

Practice Phone: 386-446-4141
Practice Fax: 386-264-6764

1609189968 — MR. FRANK C BENNETT PHYSICAL THERAPIST
Practice Location Address:

17 OLD KINGS RD N STE K
PALM COAST, FL
32137-8283

Practice Phone: 386-255-4596
Practice Fax: 386-258-3561

1558086629 — HEART OF CARRIE LLC
Practice Location Address:

17 OLD KINGS RD N STE E
PALM COAST, FL
32137-8283

Practice Phone: 386-585-4406
Practice Fax:

1316552714 — DR. TARA LEE LARKIN MD
Practice Location Address:

855 CINNAMON BEACH WAY
PALM COAST, FL
32137

Practice Phone: 904-465-5136
Practice Fax:

Directions to “ORTHOPAEDIC CLINIC OF DAYTONA BEACH PA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.